Extradural sufentanil by patient-controlled analgesia or nurse-administered compared with optimal morphine in a high dependency unit: effects on oxygenation and pain relief after abdominal surgery.

The incidence of apnoeic episodes (> 12 s) was measured in 30 surgical patients allocated randomly to one of three analgesic regimens and all nursed in a high dependency unit. Ten patients received i.m.

The Australian Incident Monitoring Study. Equipment failure: an analysis of 2000 incident reports.

Of the first 2000 incidents reported to the Australian Incident Monitoring Study, 177 (9%) were due to "pure" equipment failure according to pre-defined criteria. Of these 107 (60%) involved anaesthetic equipment, 42 (24%) involved monitors, 17 (10%) other theatre equipment and 11 (6%) the gas or electricity supply. Ninety-seven (55% of the 177) were potentially life-threatening; of these two-thirds would be detected by the array of monitors recommended by the Australian and New Zealand College of Anaesthetists and all but 9 of the remainder would be handled by application of the crisis management algorithm recommended elsewhere in this symposium.

The Australian Incident Monitoring Study. Crisis management--validation of an algorithm by analysis of 2000 incident reports.

Anaesthetists are called upon to manage complex life-threatening crises at a moment's notice. As there is evidence that this may require cognitive tasking beyond the information-processing capacity of the human brain, it was decided to try and develop a generic crisis management algorithm analogous to the "Phase I" immediate response routine used by airline pilots. Such an algorithm, based on the mnemonic "COVER ABCD, A SWIFT CHECK", was developed and refined over 3 meetings, each attended by 60-100 anaesthetists and aviation psychologists.

The Australian Incident Monitoring Study. The stethoscope: applications and limitations--an analysis of 2000 incident reports.

The first 2000 incidents reported to the Australian Incident Monitoring Study (AIMS) were analysed with respect to the role of the oesophageal or precordial stethoscope as a continuous monitor. There were 1099 of the 1256 incidents during general anaesthesia in which one might have been used in this way, but use was reported in only 65 cases (5%), predominantly during paediatric cases. In only one report, a cardiac arrest, was the stethoscope the first to detect the incident.

The Australian Incident Monitoring Study. Blood pressure monitoring--applications and limitations: an analysis of 2000 incident reports.

Of the first 2000 incidents reported to the Australian Incident Monitoring Study, 1256 occurred in relation to general anaesthesia and 81 of the latter were first detected by blood pressure (BP) monitoring. A further 25 incidents not associated with general anaesthesia were first detected by blood pressure monitoring, giving a total of 106. In the monitor detection of incidents in relation to general anaesthesia, BP monitoring ranked fourth after oximetry, capnography and low pressure alarms.